Speaking Out for Maternal Mental Health

On Saturday I attended the Maternal Mental Health event at the Cumbria Infirmary, hosted by the Happy Mums Foundation and the World Health Innovation Summit (WHIS). I was invited to speak about my experiences so that I might be able to help the professionals understand what a traumatic pregnancy and birth can be like for women. So that they might better understand the things that they can do to help. So that other women like me might not fall through the cracks for so long.

It is always hard to speak about what happened with my son’s birth. And last week was a big week for me because I finally had my debrief, and I also had my second CBT counselling session. And then there was the PTSD diagnosis.

I’d like to say that seeing those four letters on the page came as no shock (hadn’t I always known that I wasn’t depressed? Hadn’t I aways known that there was something more, likely to be PTSD?) but actually I’ve really struggled with knowing that someone else agrees with me at last. Someone else, who is professionally qualified to do so, is taking control of my care now. It feels strange. To hear her tell me she will never ask me to fill in a PND questionnaire. To hear her tell me I have been traumatised. To hear her tell me she believes me, she is sorry for what has happened, and she intends to help. It’s all so new for me, and the effects of it are still coursing their way through my life right now.

I was in two minds about Saturday. I was scared. Not of speaking, but of getting there. Making my way to the train station, sitting on a train, finding the venue. Even knowing that Jenny would be there at the station in Carlisle was very little comfort, and this is a perfect example of just how far reaching my birth trauma has been. The thought of travelling alone to Carlisle was terrifying and had it not been for Jenny I would not have gone at all.

But I did. And I spoke- to the Mayor of Carlisle and his wife, to Gareth, the founder of WHIS. To the lovely lovely ladies at The Happy Mums Foundation. To student midwives, to midwives, to obstetricians and specialists. And I apologise because I did not read out what I had carefully written down. And so, because I was asked to, I’ve copied my official presentation below.

In ten days time my son will be seven years old. This time of year is always really hard for me, because while the children are busy getting excited for Christmas, and Luka is beside himself with excitement for his birthday (which usually involves lots of lego!), I am kind of stuck in a bit of a limbo. I’m torn between wanting to be happy, to celebrate his special day, and needing to feel happy. So the more I get swept along in the process of organising and buying, baking and wrapping, the more I push my feelings and thoughts to one side. Its the same every year. I refuse to allow myself any time at all, to think or to remember. And usually what this means is that I find it harder and harder to shake the feeling that my heart might actually snap in two after all.

My son’s birth was traumatic. At my first CBT session two weeks ago, that word ‘traumatic’ was used to describe what had happened. I only managed to tell her the bare bones of my story, because it’s still- seven years on- too hard for me to speak about. Even still, I was amazed that a medical professional had voiced out loud what I have been trying to explain for so long. Trauma. My son’s birth was traumatic. It wasn’t all in my head, after all.

After Luka was born, he spent an hour by himself while I was being stitched up and taken to recovery. I’d had general anaesthetic so I’d missed his birth completely, and when I woke up he was in my husband’s arms. He was wrapped in a blue blanket. He had been cleaned. He had been weighed. He had even been named. This memory is possibly one of the hardest for me, because it was the moment I realised that I didn’t know who this baby was. I didn’t want to hold him. I didn’t want to feed him. I didn’t even believe he was mine. I’d gone from being in labour, feeling every contraction, crying in pain… to nothing. Numbness. Confusion. An empty head. And a baby they were saying was mine.

In the months that followed, I struggled on a daily basis to bond with my son. I was terrified to be alone in the house with him and I have lost count of the number of times I had to call my husband to come home from work to help me. He wasn’t my first baby, but the thought of having to care for him by myself was enough to bring on a panic attack. It didn’t help that my son had a few health issues and rarely slept, so he wasn’t an easy baby either. I think the fact that he cried so much had a huge impact on my own already delicate mental health, and to be told that my stress was probably causing him to cry was probably one of the lowest points for me during his first year. So not only was I to blame for his birth going wrong, but I was to blame for his misery in life too.

Much of my son’s first year is a blur to me now, and I will never ever get that time back. I will never again be able to hold my newborn son, bend my head down to kiss his little soft cheek, and tell him that I love him. I don’t even know if I ever did that, my heart tells me I probably didn’t. I did love him, but I just didn’t know it at first. And that’s really hard to deal with.

I’ve had two other babies since my son was born, and happily they were both fairly straight forward deliveries. But I wanted to speak for a moment about those pregnancies after birth trauma. Because a pregnancy after birth trauma isn’t the same as another pregnancy, or at least it wasn’t for me. There wasn’t really much excitement or joy. Despite being told over and again how lucky I was to have two healthy babies already, for me this wasn’t good enough. It matters that my baby was healthy despite his birth, but I mattered too. Despite being told over and again how magical pregnancy was and how lucky I was to be carrying my third, and then fourth babies, I could not believe in that joy. Despite being told that everything would be ok this time, I already knew how badly things could go wrong.

I spent much of the early days of my third pregnancy in tears. The nightmares were almost constant and the anxiety was horrific. Luka was only 15 months old and he pregnancy was a huge shock to everyone around me, as they assumed he would be my last. I felt hugely unsupported by family initially, and also by my medical team too. We switched hospitals this time, but even still I never really had the chance to talk about what had happened during my last birth. That ‘listening’ service just didn’t exist, at a time when I really needed it to. The thought of going through another horrible experience meant that I wasn’t eating or sleeping and concentrating on work was almost impossible. I had no idea what lay ahead of me.

As it happens, my third pregnancy was, thankfully, very calm in the end and my daughter’s birth was gentle, happy and peaceful. And the early days with her were so different to the early days with my son- so much so that it brought home even more how horrific those days had been. I think my heart broke for him on an almost daily basis. It still does.

Unfortunately my fourth pregnancy wasn’t calm, and if you’ve read my blog at all you’ll know why. My youngest was diagnosed with IUGR at 29 weeks and we spent the remainder of the pregnancy back and forth to the hospital for monitoring, scans and various other appointments. She was born via c-section at 37 weeks and we were discharged the next day.

As I stand here now, I could weep for the me that left the hospital with that tiny newborn two years ago. I’d been pushed through an enhanced recovery program and discharged before my daughter had even had her first feed. I was sent home to three other children less than 36 hours after major surgery, the fourth of its kind. The pain was excruciating and the anxiety I felt watching my baby literally fade before my eyes was awful. Elsie was syringe fed for days and didn’t even open her eyes until she was one week old. That was really hard. We thought we were losing her, and if it wasn’t for Emma reaching out to me via Twitter I’m not sure I would have got through it at all.

Emma runs Unfold Your Wings, and meeting her has been an amazing turning point for me. Speaking to someone with so much compassion, kindness and understanding has been a literal life saver for me. Since we set up #BirthTraumaChat we have spoken to so many women who have suffered in similar ways, and who have also struggle to find the help they need. So many women are experiencing stressful pregnancies or traumatic births, and are expected to just go home and get on with it. So many of these women are falling through the gaps when they should be embraced. They should be helped.

I am almost seven years on from my son’s traumatic birth, and just starting CBT counselling. I always assumed that whatever I had been through would work itself out eventually, but lately I’ve come to realise that just isn’t happening. I’m suffering from trauma related anxiety; I suffer with insomnia; I am collecting triggers left right and centre. I am not getting better, and it seems that no amount of time between me and what happened will change that just yet.

Sadly, I am not alone. There are other women who are experiencing trauma who are not getting the help they need. Sometimes they can’t reach out and ask for it. Sometimes they don’t know they need it. Sometimes it just isn’t there at all.

As Unfold Your Wings, Emma works hard to raise awareness of birth trauma and PTSD, and through Maternity Matters Jenny and I are attempting to raise awareness of a range of maternity experiences, so that women and their families can feel empowered, supported and inspired. We’ve come up with a list of actions we believe will help women:

Listen. Let her talk when she’s ready, and actually listen. Don’t be afraid to ask her how she feels about her birth experience, and if she cannot tell you with words, then take notice of her actions. Sometimes, some women find it hard to talk about what happened and will prefer to not speak at all. Sometimes they will want to talk almost obsessively about what happened. I was the latter- I needed to discuss what happened almost constantly, yet I could not speak to medical professionals at all. Which leads me on to…

Encourage peer to peer support. Speaking to other women who have experienced similar can be an amazing source of support. Being able to talk without judgement, to listen without expectations, and to share is essential. #BirthTraumaChat aims to be a safe place for women to talk each week, and there are also online groups that serve the same purpose. I’d like to see more birth reflections groups too, so that women can meet up and form friendships in their local areas too.

Choose your words carefully. Lots of women tell us that they will never forget the words that were spoken to them during pregnancy, birth and beyond. And the way that words are delivered are important too. I will never forget being told that I was being ‘silly’ when in fact I was absolutely terrified that my baby was dying. I was asked why I was crying, and told that I was ‘catastrophising’. Those words did not comfort me. They led to years of shame, guilt and fear instead. Language matters!

Show kindness and compassion. A lovely midwife came to see my just after I was taken up to the ward. I was sore, weepy and tired. For a long time she didn’t speak, she just held my hand and waited while I cried. I don’t remember her name and all I know was that she had been with me during delivery, and her kindness will never be forgotten. When she left she kissed my cheek and told me she was sorry, and that was my permission to grieve.

Show respect. Don’t talk about women as if they are not in the room. Don’t perform examinations or procedures without explanations or consent. Don’t make her feel that her emotions are not valid or that she is to blame. Knock before you enter the room, or ask before you pull back the curtain.

Put yourself in her shoes.

Support women’s choices so that they can feel empowered and in control.

Communicate. So much of my trauma could have been prevented with better communication. I wasn’t told that I was going down to theatre because the monitor had lost my son’s heartbeat. I wasn’t told he was stuck and needed to come out quickly. I wasn’t told I would be given general anaesthetic, or that my husband wouldn’t be allowed into theatre with me. I wasn’t even told that my son was resuscitated after birth. Communication is essential to help women make informed choices and to feel supported and cared for.

2 Comments

This is a fantastic post, I had birth trauma and severe PND and I’m a midwife. I had a lot of trouble coming to terms worth the fact I had to go back to work in an environment that made me ill. Great tips as well, all so important.